Comparison of Baseline Characteristics and Inhospital Outcomes of Patients and Use of Bare Metal Versus Drug-Eluting Stents During Percutaneous Coronary Intervention 2005 to 2015 at a Single Tertiary Hospital

Autor: Michael J. Lipinski, Sarkis Kiramijyan, Michael A. Gaglia, Rebecca Torguson, Smita I. Negi, Jiaxiang Gai, Edward Koifman, Augusto D. Pichard, Ron Waksman, Romain Didier
Rok vydání: 2017
Předmět:
Male
medicine.medical_treatment
030204 cardiovascular system & hematology
Hematocrit
Tertiary Care Centers
Postoperative Complications
0302 clinical medicine
Hospital Mortality
030212 general & internal medicine
media_common
education.field_of_study
medicine.diagnostic_test
Cardiogenic shock
digestive
oral
and skin physiology
Drug-Eluting Stents
Acute Kidney Injury
Middle Aged
Stroke
Treatment Outcome
Metals
Cardiology
Female
Stents
Gastrointestinal Hemorrhage
Cardiology and Cardiovascular Medicine
Drug
medicine.medical_specialty
Acute coronary syndrome
media_common.quotation_subject
education
Population
Shock
Cardiogenic
Postoperative Hemorrhage
Prosthesis Design
03 medical and health sciences
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
Blood Transfusion
Acute Coronary Syndrome
Aged
business.industry
Percutaneous coronary intervention
Stent
Length of Stay
medicine.disease
stomatognathic diseases
Multivariate Analysis
Conventional PCI
business
Zdroj: The American Journal of Cardiology. 119:1324-1330
ISSN: 0002-9149
DOI: 10.1016/j.amjcard.2017.01.016
Popis: With steady growth in the use of drug-eluting stents (DES), the indications for bare metal stents (BMS) have significantly changed over the last decade. This study aims to describe trends in the use of BMS and the evolution of the population receiving them over the past 10 years and determine patient characteristics associated with using BMS. Consecutive patients who underwent percutaneous coronary intervention (PCI) at the Washington Hospital Center from January 2005 through March 2015 were included. Baseline characteristics and inhospital outcomes of patients who underwent PCI with BMS versus DES were compared during 2 different time periods: from 2005 to 2010 and from 2011 to 2015. Multivariable analyses were performed for each period of time to determine independent variables associated with the choice of BMS rather than DES; 20,321 patients who underwent PCI were included in the present study. The mean age was 65.0 ± 12.5 years, 65.2% were men, and 30.4% were black. BMS use peaked in 2007 (47%) but has fallen steadily since; BMS accounted for only 10% of stents used in 2015. Presentation with acute coronary syndrome or cardiogenic shock was more common in patients receiving a BMS; this was reflected in higher rates of inhospital mortality and major bleeding among patients receiving BMS versus DES. Covariables independently associated with receiving a BMS common to both time periods included black race, Hispanic ethnicity, cardiogenic shock or acute coronary syndrome, oral anticoagulation, current smoking, increasing age, lower hematocrit, and history of chronic renal insufficiency. In conclusion, there has been a precipitous decline in the use of BMS over the last decade. Newer stent technology that promises shorter duration of dual antiplatelet therapy is likely to lead to the extinction of BMS over the next decade.
Databáze: OpenAIRE
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